Hypopharyngeal cancer is a disease in which malignant (cancer)
cells form in the tissues of the hypopharynx.
Use of tobacco products and heavy drinking can affect the risk
of developing hypopharyngeal cancer.
Signs and symptoms of hypopharyngeal cancer include a sore throat
and ear pain.
Tests that examine the throat and neck are used to help detect
(find) and diagnose hypopharyngeal cancer.
Certain factors affect prognosis (chance
of recovery) and treatment options.
Hypopharyngeal cancer is a disease in which malignant (cancer)
cells form in the tissues of the hypopharynx.
The hypopharynx is the
bottom part of the pharynx (throat).
The pharynx is a hollow tube about 5 inches long that starts behind the nose, goes down the neck,
and ends at the top of the trachea (windpipe) and esophagus (the tube
that goes from the throat to the stomach). Air and food pass through the pharynx on
the way to the trachea or the esophagus. EnlargeHypopharyngeal cancer forms in the tissues of the hypopharynx (the bottom part of the throat). It may spread to nearby tissues or to cartilage around the thyroid or trachea, the bone under the tongue (hyoid bone), the thyroid, the trachea, the larynx, or the esophagus. It may also spread to the lymph nodes in the neck, the carotid artery, the tissues around the upper part of the spinal column, the lining of the chest cavity, and to other parts of the body (not shown).
Most hypopharyngeal cancers form in squamous cells,
the thin, flat cells lining the inside of the
hypopharynx. The hypopharynx has 3 different areas. Cancer may be found in 1 or more of these areas.
Use of tobacco products and heavy drinking can affect the risk
of developing hypopharyngeal cancer.
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors include the following:
Signs and symptoms of hypopharyngeal cancer include a sore throat
and ear pain.
These and other signs and symptoms may be caused by hypopharyngeal cancer or by other conditions.
Check with your doctor if you have any of the following:
A sore throat that does not go away.
Ear pain.
A lump in the neck.
Painful or difficult swallowing.
A change in voice.
Tests that examine the throat and neck are used to help detect
(find) and diagnose hypopharyngeal cancer.
The following tests and procedures may be used:
Physical exam of the throat: An exam in which
the doctor feels for swollen lymph
nodes in the neck and looks down the throat with a small,
long-handled mirror to check for abnormal areas.
CT scan (CAT
scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.EnlargeComputed tomography (CT) scan of the head and neck. The patient lies on a table that slides through the CT scanner, which takes x-ray pictures of the inside of the head and neck.
PET scan (positron emission tomography scan): A procedure to find malignanttumor cells in the body. A small amount of radioactiveglucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. A PET scan and CT scan may be done at the same time. This is called a PET-CT.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.
Barium esophagogram: An x-ray of the esophagus. The patient drinks a liquid that contains barium (a silver-white metalliccompound). The liquid coats the esophagus and x-rays are taken.
Endoscopy: A
procedure used to look at areas in the throat that cannot be seen
with a mirror during the physical exam of the throat. An endoscope (a thin, lighted tube) is inserted through the
nose or mouth to check the throat for anything that seems unusual. Tissue samples may be taken for biopsy.
Esophagoscopy: A procedure to look inside the esophagus to check for abnormal areas. An esophagoscope (a thin, lighted tube) is inserted through the mouth or nose and down the throat into the esophagus. Tissue samples may be taken for biopsy.
Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope (a thin, lighted tube) is inserted through the nose or mouth into the trachea and lungs. Tissue samples may be taken for biopsy.
Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer.
Certain factors affect prognosis (chance
of recovery) and treatment options.
The stage of the cancer (whether it
affects part of the hypopharynx, involves the whole hypopharynx, or has spread
to other places in the body). Hypopharyngeal cancer is usually detected in later stages because early signs and symptoms rarely occur.
Keeping the patient's ability to talk, eat, and breathe as normal as possible.
The patient's general health.
Patients who have had hypopharyngeal cancer are at an increased risk of developing a second
cancer in the head or neck. Frequent and
careful follow-up is important.
Stages of Hypopharyngeal Cancer
Key Points
After hypopharyngeal cancer has been diagnosed, tests are done
to find out if cancer cells have spread within the hypopharynx or to other
parts of the body.
There are three ways that cancer spreads in the body.
Cancer may spread from where it began to other parts of the body.
The following stages are used for hypopharyngeal
cancer:
Stage 0 (Carcinoma in Situ)
Stage I
Stage II
Stage III
Stage IV
After hypopharyngeal cancer has been diagnosed, tests are done
to find out if cancer cells have spread within the hypopharynx or to other
parts of the body.
The process used to find out if cancer has spread within the hypopharynx or to other parts of the
body is called staging. The
information gathered from the staging process determines the stage of the disease. It is
important to know the stage of the disease in order to plan treatment.
The results of some of the tests used to diagnosehypopharyngeal cancer are often also used to stage the disease.
There are three ways that cancer spreads in the body.
Tissue. The cancer spreads from where it began by growing into nearby areas.
Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
Cancer may spread from where it began to other parts of the body.
When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if hypopharyngeal cancer spreads to the lung, the cancer cells in the lung are actually hypopharyngeal cancer cells. The disease is metastatic hypopharyngeal cancer, not lung cancer.
The following stages are used for hypopharyngeal
cancer:
is larger than 4 centimeters or has spread to the larynx (voice box) or esophagus. Cancer may have spread to one lymph node on the same side of the neck as the tumor and the lymph node is 3 centimeters or smaller; or
has spread to one lymph node on the same side of the neck as the tumor and the lymph node is 3 centimeters or smaller and cancer is found:
in one area of the hypopharynx and/or is 2 centimeters or smaller; or
in more than one area of the hypopharynx or in nearby tissues, or is larger than 2 centimeters but not larger than 4 centimeters and has not spread to the larynx.
has spread to cartilage around the thyroid or trachea, the bone under the tongue, the thyroid, or nearby soft tissue. Cancer may have spread to one lymph node on the same side of the neck as the tumor and the lymph node is 3 centimeters or smaller; or
has spread to one lymph node on the same side of the neck as the tumor (the lymph node is larger than 3 centimeters but not larger than 6 centimeters) or to lymph nodes anywhere in the neck (affected lymph nodes are 6 centimeters or smaller), and one of the following is true:
cancer is found in one area of the hypopharynx and/or is 2 centimeters or smaller; or
cancer is found in more than one area of the hypopharynx or in nearby tissues, or is larger than 2 centimeters but not larger than 4 centimeters and has not spread to the larynx (voice box); or
cancer has spread to the larynx or esophagus and is more than 4 centimeters; or
cancer has spread to cartilage around the thyroid or trachea, the bone under the tongue, the thyroid, or nearby soft tissue.
has spread to muscles around the upper part of the spinal column, the carotid artery, or the lining of the chest cavity and may have spread to lymph nodes which can be any size; or
may be any size and has spread to one or more lymph nodes that are larger than 6 centimeters.
In stage IVC, the tumor may be any size and has spread beyond the hypopharynx to
other parts of the body.
There are different types of treatment for patients with
hypopharyngeal cancer.
Three types of standard treatment are used:
Surgery
Radiation therapy
Chemotherapy
New types of treatment are being tested in clinical
trials.
Patients may want to think about taking part in a clinical trial.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Follow-up tests may be needed.
There are different types of treatment for patients with
hypopharyngeal cancer.
Different types of treatment are available for patients with hypopharyngeal cancer. Some treatments
are standard (the currently used treatment), and some are being tested in clinical trials. A
treatment clinical trial is a research study meant to help improve current
treatments or obtain information on new treatments for patients with cancer.
When clinical trials show that a new treatment is better than the
standard treatment, the new
treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Three types of standard treatment are used:
Surgery
Surgery (removing the cancer in
an operation) is a common treatment for all stages of hypopharyngeal cancer. The following
surgical procedures may be used:
Laryngopharyngectomy: Surgery to remove the larynx (voice box) and part of
the pharynx (throat).
Partial laryngopharyngectomy: Surgery to remove part of the
larynx and part of the pharynx. A partial laryngopharyngectomy prevents loss of
the voice.
Even if the doctor removes all the cancer that can be seen at the
time of the surgery, some patients may be given chemotherapy or radiation
therapy after surgery to kill any cancer cells that are left. Treatment given
after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:
External radiation therapy uses a machine outside the body to send radiation toward the cancer. EnlargeExternal-beam radiation therapy of the head and neck. A machine is used to aim high-energy radiation at the cancer. The machine can rotate around the patient, delivering radiation from many different angles to provide highly conformal treatment. A mesh mask helps keep the patient’s head and neck from moving during treatment. Small ink marks are put on the mask. The ink marks are used to line up the radiation machine in the same position before each treatment.
The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy is used to treat hypopharyngeal cancer.
Radiation therapy may work better in patients who have
stopped smoking before beginning treatment. External radiation therapy to the thyroid or the pituitary gland may change the way
the thyroid gland works. A blood test to check the thyroid hormone level in the body may be done before
and after therapy to make sure the thyroid gland is working properly.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Chemotherapy may be used to shrink the tumor before surgery or radiation therapy. This is called neoadjuvant chemotherapy.
New types of treatment are being tested in clinical
trials.
Information about clinical trials is available from the
NCI website.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
For hypopharyngeal cancer, follow-up to check for recurrence should include careful head and neck exams once a month in the first year after treatment ends, every 2 months in the second year, every 3 months in the third year, and every 6 months thereafter.
Partial laryngopharyngectomy with or without high-dose radiation
therapy to the lymph nodes on both sides of the neck.
Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage I hypopharyngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.
A clinical trial of chemotherapy followed by
radiation therapy or surgery.
Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage II hypopharyngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.
Chemotherapy given during or after radiation therapy or after surgery.
A clinical trial of chemotherapy followed by surgery and/or radiation
therapy.
A clinical trial
of chemotherapy given at the same time as radiation therapy.
A clinical trial of surgery followed by chemotherapy given at the same time as radiation therapy.
Treatment and follow-up of stage III hypopharyngeal cancer is complex and is ideally overseen by a team of specialists with experience and expertise in treating this type of cancer. If all or part of the hypopharynx is removed, the patient may need plastic surgery and other special help with breathing, eating, and talking.
Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage III hypopharyngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.
A clinical trial of surgery followed by chemotherapy given at the same time as radiation therapy.
Surgical treatment and follow-up of stage IV hypopharyngeal cancer is complex and is ideally overseen by a team of specialists with experience and expertise in treating this type of cancer. If all or part of the hypopharynx is removed, the patient may need plastic surgery and other special help with breathing, eating, and talking.
Treatment of stage IV hypopharyngeal cancer that cannot be treated
with surgery may include the following:
Radiation therapy.
Chemotherapy given at the same time as radiation
therapy.
A clinical trial of radiation therapy with chemotherapy.
Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage IV hypopharyngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.
Treatment Options for Recurrent and Metastatic Hypopharyngeal Cancer
Treatment of hypopharyngeal cancer that has recurred (come back) or that has spread to other parts of the body may include the
following:
Check the list of NCI-supported cancer clinical trials that are now accepting patients with recurrent hypopharyngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.
To Learn More About Hypopharyngeal Cancer
For more information from the National Cancer Institute about hypopharyngeal cancer, see the following:
Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.
PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.
Purpose of This Summary
This PDQ cancer information summary has current information about the treatment of hypopharyngeal cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
Reviewers and Updates
Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.
The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.
Clinical Trial Information
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Clinical trials are listed in PDQ and can be found online at NCI's website. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
Permission to Use This Summary
PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 2,000 scientific images.
Disclaimer
The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.
Contact Us
More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website’s E-mail Us.
